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Dem Bones
By Allan Tissenbaum, M.D.

Dear GeezerJock Doc: I have been diagnosed with osteoporosis; can you tell me how it's treated and whether athletic activity can help fight the disease's effects?

That's a very relevant question. Bone health is very important for everyone growing older, especially women. Even though age does weaken bones, take heart, because there are ways to improve the strength of your bones and increase their resistance to fracture.

Osteoporosis is a disease in which the bone structure becomes weaker and is more susceptible to fractures. The difficulty with this disease is that it is insidious in onset: The first indication of the disease usually is a fracture. Bone is a living tissue that is constantly changing throughout one's life. Bone is formed by a combination of a protein collagen that has both calcium and phosphorus distributed on the proteins to help strengthen the collagen. (99 percent of the body's calcium is stored in the bones and teeth). Throughout one's life bone is being added and replaced. After the age of 30 the rate of bone deposition is slower than the rate of absorption. When the rate speeds up even faster, osteoporosis occurs.

There are many risk factors for osteoporosis:

  • Gender. Women are four times more likely to develop osteoporosis. Women have smaller bones and store less of the minerals that make up bone. And women tend to lose bone mass much faster than men after menopause.
  • Age. As we age we increase our risk for osteoporosis. Bones lose calcium and phosphorus and become less dense with the years.
  • Race. Caucasian women are more likely to develop the disease.
  • Body size. Small boned and thin women who weigh less than 127 pounds are more susceptible to osteoporosis.
  • Life choices. Cigarette smoking, excessive alcohol intake, not getting enough calcium in the diet and not participating in weight bearing exercise can increase the likelihood of the disease.
  • Early menopause. Women who have early menopause increase their risk. Excessive physical activity that leads to cessation of menstruation is also a risk.
  • Medications. Certain medications will result in a decrease in bone mass. Thyroid medications, cortisone derivatives and many others can increase the risk of osteoporosis.

The diagnosis of osteoporosis can be made easily and painlessly.The test is a simple measure of the bone density. The tests usually measure the density of the bone in the spine and the hip, the two most common bones that fracture in osteoporosis. Once the diagnosis is established the results should be discussed with your physician and a treatment plan implemented.

There is no cure for osteoporosis, but there are several simple treatments that can minimize the disease's effects. The initial treatment consists of obtaining adequate calcium and vitamin D to strengthen the bones. After the age of 30 one should consume at least 1200 mg of calcium daily. Vitamin D is an important hormone that aids in calcium absorption. One should consume 400 to 800 units a day if you are not getting enough sun exposure.

Recent research has shown that weight-bearing activities, ranging from walking to lifting weights can add to bone density. Studies have indicated that even men and women older than 80 can improve the bone density by lifting very light weights. The authors of the book "Younger Next Year" argue that weight lifting is also important for bone health in another way: It tends to improves coordination -- thus reducing the likelihood of falls resulting in broken hips.

Men, even very active athletes, should not assume that osteoporosis is a disease reserved for women. For instance, you may be very healthy from doing a lot of swimming, but because this is not a weight bearing exercise, your bones may weaken. Additionally, a major concern about long space flights, in which weightlessness is omnipresent, is the onset of osteoporosis even in a fit group of individuals such as astronauts.

Ask the Doctor
Written by orthopedic surgeon and Masters sprinter Allan Tissenbaum, M.D., GeezerJock Doc is a forum for your questions about injuries, exercise and getting older. Submit questions to geezerjockdoc@geezerjock.com or mail to GeezerJock Doc, 2033 W. Hutchinson St., Chicago, IL 60618.



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